Physiotherapists in Gourock treat many different conditions including the issues profiled below.

Tendon Bone and Ligament Bone Junctions

Tendons and ligaments have important functions in the body and their ability to perform their functions depends on their connections to the skeleton, on which they exert their forces or their restraining influences. The junction between a tendon or ligament and the bone is called an enthesis and inflammation of that area is known as enthesitis. There is an important group of arthritis conditions where the enthesis is the main site of inflammatory change, as well as normal musculoskeletal problems secondary to injury or degenerative changes. Typical conditions include ankylosing spondylitis, psoriatic arthritis and reactive arthritis.

Entheses vary in their structure: fibrous ones have the ligament or tendon continuing in their normal structure until they contact the bone; fibrocartilaginous ones have a piece of fibrocartilage on the site of attachment and it is this latter group that are mostly of interest in arthritic diseases. The cartilage makes the end of the tendon stiffer and cushions the sudden changes from flexible tendon or ligament material to the hardness of the bone. The management of the stresses which are transmitted through ligaments and tendons to the bone are complex and the body has adapted with a series of anatomical modifications.

Simple Neck and Shoulder Girdle Exercises

Slow performance of the exercises is important, taking up to five seconds to get to the end of each individual direction of movement. The neck should be moved in each of the standard directions which are: turning the head left and right; side flexing left and right (ear down to same shoulder with face facing forward); bending head forward and back; tucking the head in (a bit like a chicken). It is important to do each movement separately so the maximum range is obtained as the ends of the movement are where the value is in exercising.

Shoulder movements are useful as they may be stiff or the shoulder girdle may not be moving well, and shoulder movements stress the neck to some extent. Shrugging shoulders and rolling them backwards are an example of this movements as are circling of the arms either backwards or forwards. Once the movements are easy then some auto-resisted neck strengthening can be performed with the neck being held in place as one of the hands tries to push it out of position. Holding this for about ten seconds forces the muscles to work hard to maintain the neck position.